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?:abstract
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Study Objectives: This study sought to determine the trends in pediatric emergency department (PED) visits and utilization of resources during the Coronavirus-2019 pandemic Methods: We performed a cross-sectional study of PED visits at a free-standing community-based children’s hospital during January through April in 2016-2020 The 2020 data was reported through April 24 Data aggregation was performed for each month per year, and included total counts of PED visits, emergency department severity index (ESI) categories, dispositions (admission, discharge, death, left without treatment, and transfer), chief complaints, and average patient age (months), time from 1st Provider to Disposition (PTD) and PED length of stay (PED-LOS) Total visits for April 2020 were approximated to the entire month for comparison to prior years Total PED visits, percentage of ESI categories, age, PTD time, PED-LOS, and percentage of admissions for the same month were averaged from 2016-2019 and compared with the same month in 2020 using ANOVA A p-value <0 01 was considered statistically significant Results: In total, 67,290 visits were reported for January through April from 2016 to 2020 There was a significant decrease (p<0 001) in PED visits in March (2,732) and April (972) in 2020, compared to the same time period in prior years April 2020 had a significantly shorter average LOS (from 161 to 124 minutes, p<0 01) (Table 1) and increase of admissions (from 8% to 13%, p<0 001) Cases based on ESI showed a trended decrease in ESI 4-5, and a relative increase in ESI 1-3, albeit not statistically significant There was no difference in average monthly PTD time Fever and cough chief complaints were significantly higher in March 2020 vs 2016-2019 (40% vs 30%;SD 1 5%, p=0 01) Conclusion: During the Coronavirus-2019 pandemic, patient flow in the PED was affected There was a decrease in PED visits and a parallel decrease in overall LOS These may be linked, but changes in protective practices and other processes to address the pandemic should be explored to clarify contributions There was an increase in admission rate that may be related to higher acuity at presentation to the PED This could be elucidated by further study focusing on specific diagnoses and markers of acuity By understanding the interaction between hospital processes and patient factors during a pandemic and other public health emergencies on PEDs, we are able to anticipate and better allocate resources in the future [Formula presented]
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